非增强、自由呼吸、3D-TFE-WH序列冠状动脉成像与CTA的对比研究

目的 评价非增强、自由呼吸、3D-TFE-WH序列对冠状动脉各节段图像质量及管腔狭窄的显示能力。 方法 招募10例志愿者为研究对象，于同日依次接受冠状动脉磁共振血管造影（magnetic resonance angiography，MRA）检查和CT血管造影（CT angiography，CTA）检查。分段评价MRA检查及CTA检查图像质量，并以冠状动脉CTA作为标准，评价冠状动脉MRA显示管腔狭窄的能力。 结果 10例志愿者冠状动脉血管共90段，冠状动脉MRA检查血管满足诊断要求83段（92.2%），CTA检查血管满足诊断要求90段（100.0%）。2种检查方法显示近中段血管图像质量差异无统计学意义（P＞0.05），MRA检查左前降支远段、左回旋支远段、右冠状动脉远段图像质量评分低于CTA检查（P＜0.05）。MRA显示管腔狭窄6段，轻微狭窄2段，轻度狭窄4段。CTA显示管腔狭窄8段，轻微狭窄6段，轻度狭窄2段。以CTA检查为标准，MRA检查高估狭窄4段，低估狭窄5段。有2段CTA检查显示轻微狭窄MRA不能评价。2种检查方法显示管腔狭窄能力的一致性为中等（Kappa值=0.656）。 结论 非增强、自由呼吸、3D-TFE-WH序列对冠状动脉近中段图像质量及轻度以上管腔狭窄的显示能力与CTA相仿。此技术可作为造影剂禁忌人群进行冠状动脉疾病筛查的手段。

Comparative study between free-breathing non-contrast-enhanced 3D-TFE-WHequence coronary angiography and CTA

Objective To evaluate the image quality of free-breathing non-contrast-enhanced 3D-TFE-WH sequences in different segments of coronary artery and their ability to display lumen stenosis.Methods Ten volunteers were recruited as the research subjects and underwent coronary magnetic resonance angiography(MRA) and CT angiography(CTA) on the same day. The image quality of MRA and CTA was evaluated, and the ability of coronary MRA to display lumen stenosis was evaluated with coronary CTA as the standard.Results There were 90 segments of coronary arteries in 10 volunteers, of which 83 segments(92.2%) met the diagnostic requirements by coronary MRA and 90 segments(100.0%) by CT. There was no significant difference in image quality of proximal and mid segment blood vessels between two methods(P＞0.05). The image quality score of MRA in the distal segment of left anterior descending branch, left circumflex branch and right coronary artery was lower than that of CTA(P＜0.05). MRA showed a total of 6 segments of lumen stenosis, including 2 segments of slight stenosis and 4 segments of mild stenosis. CTA showed 8 segments of lumen stenosis, including 6 segments of slight stenosis and 2 segments of mild stenosis. Taking CTA as the standard, MRA overestimated stenosis in 4 segments and underestimated stenosis in 5 segments. Two sections of CTA showed slight stenosis, which could not be evaluated by MR. The consistency of the two examination methods in the ability of lumen stenosis was medium(Kappa value=0.656).Conclusion The image quality of free-breathingnon-contrast-enhanced 3D-TFE-WH sequence in proximal and mid segment of coronary artery and its ability to display non-mild lumen stenosis are similar to CTA. This technique can be used as a method for coronary artery disease screening in people with contraindication of contrast agents.